by Dawn Heiderscheidt, MOT, OTR/L, ECHM
April is Occupational Therapy Month! In order to celebrate this profession, it’s important to understand WHAT an Occupational Therapist (OT) is and how they connect to oncology.
The American Occupational Therapy Association (AOTA) defines OT as “the only profession that helps people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities (or occupations).” Simply put, Occupational Therapists put clients back in the driver’s seat as an active participant in their own daily lives.
“Occupations” are defined as anything meaningful that fills your day, not JUST your occupation (as in a job) – activities such as bathing, dressing all the way through leisure activities like fishing or gardening.
These therapists look at the whole person with a unique lens to identify significant indicators of declining function. These declines can suggest whether a person will need assistance to live/function independently while navigating their daily lives either from a recovery or experiencing natural aging processes or disease side effects. Although often deployed retroactively after incidents or accidents (due to insurance reimbursements), OTs are actually best utilized in a preventative manner.
Why haven’t you met an OT before? Chances are that you actually have, but you may just not have known it.
OTs are often confused for physical therapists, nurses, or even doctors (every OT thanks you for that particular vote of confidence!). It can be hard to identify a medical profession without understanding its full scope, and OTs cover NINE different domains – they work in a variety of settings from birth (helping babies born with developmental issues) through end of life care (such as hospice) and can have a role in everything in-between.
So, what are the domains and why do you care?
- Activities of Daily Living (ADLs)
- This includes activities that are oriented toward taking care of one’s own body and are completed on a daily basis such as bathing, dressing, grooming, toileting, and scar management, among others.
- These are typically the tasks that people prefer to do themselves but can be difficult with limited range of motion, reduced energy, or pain after an incident or initial treatments.
- Instrumental Activities of Daily Living (IADLS)
- IADLS incorporate the skills that support daily life within the community. For example managing finances, shopping, meal prep, house management, medication management, transportation (both driving and navigating public transportation systems), etc.
- These often are the items that individuals need help with when recovering because they take a lot of physical and mental energy to complete. They include memory, attention, and often the ability to problem-solve. These are the very core of our ability to function independently and as such can be difficult to admit the need for help.
- Health Management
- This domain covers the skills needed to develop, manage, and maintain routines for health and wellness by engaging in self-care. The goal of these skills is to improve or maintain health wherever you are in the journey.
- Anxiety is often reported as a side effect of a cancer diagnosis. As a result, OTs can help with stress management, developing systems to schedule and time medical appointments, and implement strategies to ensure follow-through of appointments. Memory aids or routine modification may be implemented in order to create an environment of success.
- Rest and Sleep
- While extremely broad, this domain relates to any and all activities related to falling asleep and obtaining restorative sleep.
- This can include engaging in routines that prepare you for sleep, including yoga and meditation. Additional support can be provided to address personal needs in preparation for sleep such as CPAP management or setting appropriate alarms.
- Most notably, OTs can provide advice on pillows and positioning or obtaining appropriate equipment/modifications needed for restful sleep. This is particularly helpful during initial recovery from surgery when wounds or excessive weakness may be present.
- This domain includes activities needed for learning and participating in an educational environment, whether from home, school.
- For patients with cancer, this particular domain may mean getting accommodations at school, regardless of the level (elementary through collegiate). OTs can help access adaptive equipment like e-readers, iPads, and voice-to-text aides, and can even help educate staff on learning strategies to help students who may be returning after diagnosis or treatment.
- This includes employment, seeking and acquisition of employment, job performance, retirement preparation, and participation in volunteer opportunities.
- Similar to the education domain, OTs can work with ergonomics departments to help find adaptive equipment that will assist you with returning to work and completing duties especially if cancer leaves you with long-lasting weakness, etc.
- Play includes activities that are intrinsically motivated, internally controlled, and freely chosen. Play is multi-dimensional and is shaped by sociocultural factors, such as socially accepted gender norms, roles, and values dictated by culture on both a large and small scale. Play is often defined as spontaneous.
- OTs often use play as a way to help regain skills and strength lost during chemo or radiation for adults and children alike. Utilizing games can help increase standing tolerance, balance, and strength while suspending reality for clients and therapists alike. Because of this, play can have both physical and mental benefits during recovery.
- This domain includes non-obligatory activities that are intrinsically motivated and engaged in during discretionary time. Leisure usually involves planning and can include time off, taking and planning vacations, or activities performed while on vacation.
- While on treatment it may be difficult to access leisure activities due to diminished strength or restrictions on distance from providers OTs can often help adapt the activity or problem-solve through hurdles allowing patients to regain access to important leisure tasks.
- Social Participation
- This domain covers activities that involve social interactions with others including family, friends, peers, and community members that support social interdependence.
- We all felt the deprivation of social participation during COVID, and like the pandemic having cancer can cause social deprivation due to compromised immune systems, energy levels, and a need to stay close to doctors.
- An OT can help modify activities and maintain access to social participation in new ways throughout treatment. They run support groups, can introduce patients to technology to reach loved ones and can teach energy conservation techniques throughout the day that will allow patients to do the things they WANT to do while adapting the things they NEED to do.
These nine domains incorporate your entire life, and Cancer can impact your entire life can be affected. It is important to consider a multi-disciplinary team that has the skills and knowledge to modify, adapt, and restore your roles so you can return to life, even in the midst of a diagnosis.
This will look different for every patient, and OTs are skilled at providing individualized approaches to treatment options that address the whole person. To learn more about Occupational Therapy, visit the American Occupational Therapy Association website.
Dawn is an Occupational Therapist and Founder of a mobile outpatient therapy practice, Aurora Independence. After switching careers from teaching she graduated from Temple University with a Masters in Occupational Therapy. Since then, she has worked in a variety of rehab settings treating a variety of diagnoses’. Currently, when not seeing clients in their home/ community she is partnered with a local 55+ community center offering online fall recovery workshops, she trains dogs and enjoys hiking the Wissahickon with her own dog, Odin.